title: Restoration of the coagulation cascade on CPB: a case report.
abstract: Coagulopathy can sometimes be observed when CPB times are prolonged. Correction of coagulopathy post CPB can present the surgical team with a number of challenges, including right ventricular volume overload, hemodilution, anemia and excessive cell salvage with further loss of coagulation factors. Restoration of the coagulation cascade on CPB may help to avoid these issues. This case report is of a 64-year-old male with a delayed diagnosis of aortic dissection. The patient presented to the cardiac surgery operating room with hepatic and renal shock/failure, with the resulting coagulopathy. The described technique is representative of a technique that we sometimes employ to restore the clotting mechanism before separating from bypass.
authors.affiliation: Division of Cardiac Surgery, Brigham & Women's/Cape Cod Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Lilly
authors.forename: P A
authors.initials: PA
authors.lastname: Pirundini
authors.forename: A A
authors.initials: AA
authors.lastname: Fox
authors.forename: S C
authors.initials: SC
authors.lastname: Body
authors.forename: C
authors.initials: C
authors.lastname: Shaw
authors.forename: R J
authors.initials: RJ
authors.lastname: Rizzo
mesh_terms: D001777:Blood Coagulation; D001779:Blood Coagulation Factors; D016913:Blood Component Transfusion; D002315:Cardiopulmonary Bypass; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010949:Plasma
chemical_list: D001779:Blood Coagulation Factors
keywords: ACT decoupling: hemoconcentration; coagulopathy; fresh frozen plasma (FFP)